Mpox surveillance: the need for enhanced testing and genomic epidemiology

Mpox and its causative pathogen, monkeypox virus, represent a growing international public health concern following a global outbreak of monkeypox virus clade II in 2022–23 and regional outbreaks of monkeypox virus clade I centred in DR Congo beginning in late 2023. Epidemiological analysis of monkeypox virus, including genomic epidemiology, is crucial to understanding the expansion of the virus within and outside its historically endemic range due to increased spillover from a zoonotic host, increased human-to-human transmission, or both, and any changes in virulence. Robust genomic epidemiology can characterise adaptation of monkeypox virus to human hosts and inform the control of ongoing mpox epidemics and prevention of future epidemics.